Poly(ester amide)-based drug delivery systems with controlled release rate and morphology

ABSTRACT

A method of forming a coating on a medical device having a controlled morphology is described. A method of treating a disorder in a patient using the medical device is described.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a divisional application of U.S. application Ser.No. 11/365,549 filed on Feb. 28, 2006, the teaching of which isincorporated by reference in its entirety herein.

FIELD OF THE INVENTION

This invention is generally related to poly(ester amide)-based drugdelivery systems.

DESCRIPTION OF THE STATE OF THE ART

Stents play an important role in a variety of medical procedures, forexample, percutaneous transluminal coronary angioplasty (PTCA), which isa procedure used to treat heart disease. In PTCA, a balloon catheter isinserted through a brachial or femoral artery, positioned across acoronary artery occlusion, inflated to compress atherosclerotic plaqueand open the lumen of the coronary artery, deflated and withdrawn.Problems with PTCA include formation of intimal flaps or torn arteriallinings, both of which can create another occlusion in the lumen of thecoronary artery. Moreover, thrombosis and restenosis may occur severalmonths after the procedure and require additional angioplasty or asurgical by-pass operation. Agent-coated stents have caused dramaticreductions in stent restenosis rates by inhibiting the tissue growthassociated with restenosis. Stents are generally implanted to reduceocclusions, inhibit thrombosis and restenosis, and maintain patencywithin vascular lumens, for example, the lumen of a coronary artery.

Stents are also being developed to provide for a means of local deliveryof agents. Local delivery of agents is often preferred over systemicdelivery, particularly where high systemic doses are necessary to treata site within a subject, but where high systemic doses create adverseeffects. Proposed local delivery methods include coating the medicalarticle surface with a polymeric carrier and attaching an agent to orblending it with the carrier.

For example, one method of applying multiple agents involves blendingthe agents together in one formulation, such as in a polymer matrix, andapplying the blend to the stent surface. A disadvantage of this methodis that the polymeric matrix morphology (arrangement of molecules in thematrix) causes the agents to release somewhat variably from thematrixcausing the agents to compete with one another for release. Insuch a blend, controlling the release of the individual agents ischallenging and can be considered unpredictable.

Controlling the performance of medical articles, for example,controlling the release of drugs, is an important aspect in medicaldevice design. In addition to improving the bioactive, biobeneficial, ordiagnostic results from administering agents, control over the releaserate is important in designing and maintaining the physical andmechanical properties of medical devices and coatings, as well, andperhaps allows for the use of more desirable polymeric matrixcomponents.

Currently, polymeric compositions frequently produce material that failsto meet desired performance characteristics. The most straightforwardway of selecting polymer components such that the mixture or compositionmeets the desired characteristics is to choose the components based ontheir individual characteristics. Unfortunately, the combinations do notalways exhibit a combination of the characteristics present in theindividual components. Polymer characteristics vary from polymer topolymer based on a host of factors that can depend on the chain-to-chaininteraction in the polymer or the arrangement of functional groups atthe polymer's surface, among other factors. But when one polymer iscombined with another, some of the factors are no longer present. Usingthe examples above, the chain-to-chain interaction in a polymercombination can differ because the types of chains differ. Similarly,the arrangement of functional groups at the surface can be differentbecause the mixture contains a different cohort of surface groups.Because factors influencing polymer characteristics change uponcombination with other polymers, components that individually havedesired characteristics do not always yield a combination thatadequately meets some desired set of performance characteristics.Furthermore, medical articles change morphologically during processingand storage, as well as after application in vivo. Unfortunately, thepredictability, and consequently the clinical utility, of a medicalarticle can rely on the ability to control these changes.

Accordingly, there is a need for control over the morphology of apolymeric matrix. The following embodiments address the above-identifiedproblems and needs.

SUMMARY

The present invention provides a method for forming a coating having acontrolled morphology for controlling the release of an agent from thecoating. In some embodiments, the method includes:

providing a coating composition comprising a polymer and a polymersolvent,

applying the coating composition onto the medical device,

inducing a phase inversion process in the composition, thereby

causing the composition to form a layer or coating on the medicaldevice.

The coating composition can include a non-solvent of the polymer. Thenon-solvent of the polymer can also be a bioactive agent. Some examplesof the agent can be paclitaxel, docetaxel, estradiol, nitric oxidedonors, super oxide dismutases, super oxide dismutases mimics,4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl (4-amino-TEMPO), biolimus,tacrolimus, dexamethasone, rapamycin, rapamycin derivatives,40-O-(2-hydroxy)ethyl-rapamycin (everolimus),40-O-(3-hydroxy)propyl-rapamycin,40-O-[2-(2-hydroxy)ethoxy]ethyl-rapamycin, and 40-O-tetrazole-rapamycin,40-epi-(N1-tetrazolyl)-rapamycin (ABT-578), pimecrolimus, imatinibmesylate, midostaurin, clobetasol, bioactive RGD, CD-34 antibody,abciximab (REOPRO), progenitor cell capturing antibody, prohealingdrugs, prodrugs thereof, co-drugs thereof, or a combination thereof.

A medical device having a coating described herein can be used to treat,prevent, or ameliorate a vascular medical condition. Some exemplaryvascular medical conditions include atherosclerosis, thrombosis,restenosis, hemorrhage, vascular dissection or perforation, vascularaneurysm, vulnerable plaque, chronic total occlusion, claudication,anastomotic proliferation for vein and artificial grafts, bile ductobstruction, ureter obstruction, tumor obstruction, and combinationsthereof.

BRIEF DESCRIPTION OF THE DRAWING

FIG. 1 is a ternary phase diagram of a poly(ester amide)/drug/solventsolution.

DETAILED DESCRIPTION

The present invention provides a method for forming a coating having acontrolled morphology for controlling the release of an agent from thecoating. In some embodiments, the method includes:

providing a coating composition comprising a polymer and a polymersolvent,

applying the coating composition onto the medical device to form a layerof the composition on the medical device,

inducing a phase inversion process in the layer, thereby

causing the layer to form the coating on the medical device.

The coating composition can include a non-solvent of the polymer. Thenon-solvent of the polymer can also be a bioactive agent such as a drug.Some examples of the agent can be paclitaxel, docetaxel, estradiol,nitric oxide donors, super oxide dismutases, super oxide dismutasesmimics, 4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl (4-amino-TEMPO),biolimus, tacrolimus, dexamethasone, rapamycin, rapamycin derivatives,40-O-(2-hydroxy)ethyl-rapamycin (everolimus),40-O-(3-hydroxy)propyl-rapamycin,40-O-[2-(2-hydroxy)ethoxy]ethyl-rapamycin, and 40-O-tetrazole-rapamycin,40-epi-(N1-tetrazolyl)-rapamycin (ABT-578), pimecrolimus, imatinibmesylate, midostaurin, clobetasol, bioactive RGD, CD-34 antibody,abciximab (REOPRO), progenitor cell capturing antibody, prohealingdrugs, prodrugs thereof, co-drugs thereof, or a combination thereof. Insome embodiments, the agent or drug can be soluble in the polymer matrixof the coating.

A medical device having a coating described herein can be used to treat,prevent, or ameliorate a vascular medical condition. Some exemplaryvascular medical conditions include atherosclerosis, thrombosis,restenosis, hemorrhage, vascular dissection or perforation, vascularaneurysm, vulnerable plaque, chronic total occlusion, claudication,anastomotic proliferation for vein and artificial grafts, bile ductobstruction, ureter obstruction, tumor obstruction, and combinationsthereof.

Phase Inversion

Phase inversion is a process in which, for example, a concentratedpolymer solution is converted into a solid network (e.g., a solid gelnetwork) with desirable properties. In a phase inversion process, apolymer solution can be quenched to, for example, a region in its phasediagram (see FIG. 1) where the polymer can phase separate into apolymer-rich phase (e.g., a continuous polymer-rich phase) thatsurrounds a dispersed non-solvent-rich phase. The quench can be achievedby several mechanisms. For example, a non-solvent can trigger the phaseinversion in a coating. Some other examples of means to induce the phaseinversion in a coating include, but are not limited to, lyophilizationof the solvent or extracting the solvent from the polymer by using anon-solvent where the non-solvent and solvent can be mutually miscible.In some embodiments, phase inversion can be induced by other meansincluding, e.g., supercritical fluid extraction of the solvent from thepolymer, removing the solvent by freeze drying, removing the solvent byheating under vacuum, or removing the solvent by vacuum at roomtemperature.

In some embodiments utilizing a single solvent system, a quenchmechanism can be a temperature change, such as freezing or evaporationof the solvent. For a multiple solvent system, having a solvent and atleast a non-solvent where the non-solvent has a higher boiling pointthan the solvent, evaporating the solvent and allowing the non-solventto remain in the system can induce phase inversion. In some embodiments,a quench mechanism can be condensation or absorption of water into acoating during the coating process (e.g., in the coating step or dryingstep). Water can be a non-solvent of a polymer such as poly(ester amide)(PEA) and thus can trigger phase inversion in a coating that includesthe polymer.

In some embodiments, in a phase inversion process, polymer solutions canbe dilute.

In various embodiments, a phase inversion process can convert a polymersolution into a polymer membrane with or without residual solvent, andwith or without dissolved or phase separated agents or drugs. IN someembodiments, agents or drugs are referred to as non-solvents.

In some embodiments, the quench is thermally induced to cause phaseinversion. For example, the processes of spray coating and subsequentdrying can cause rapid evaporation of a solvent, which cools thecoating, resulting in a thermally induced phase transition (phaseinversion). In some embodiments, phase inversion in the coating can beinduced with a cold stream of gas or induced in a cold environment.

As used herein, the term “solvent” refers to a solvent of a polymer in acoating (e.g., a poly(ester amide) (PEA)). Solvents for a coatingpolymer include, but are not limited to, for example, CH₂Cl₂,chloroform, ethanol, isopropanol, n-propanol, dimethylformamide,dimethylacetamide, dimethylsulfoxide. In some embodiments, the solventcan be alcohols (e.g., methanol, ethanol, 1,3-propanol, 1,4-butanol),heptane, hexane, pentane, cyclohexanone, trichloroethane, acetone,tetrahydrofuran (THF), dimethyl acetamide (DMAc), dioxane, toluene,xylene, dimethyl sulfoxide (DMSO), dimethyl formamide (DMF), ethylacetate, methyl ethyl ketone (MEK), and acetonitrile.

The term “non-solvent” refers to a non-solvent of a polymer in a coating(e.g., a poly(ester amide) (PEA)). Solvents and non-solvents are polymerdependent. Therefore, non-solvents for a coating polymer can include anyof the solvent described above. Some examples of non-solvents include,but are not limited to, water, dioxane, acetone, toluene, cyclohexanone,methylethyl ketone, benzene, toluene, xylene, pentane, hexane,cyclohexane, octane, or a drug such as everolimus.

Table 1 summarizes some examples of solvents or non-solvents of apolymer.

TABLE 1 PEA Polymer Solvent Non-solvent PEA-TEMPO, PEA-Benzyl Methanol,Ethanol, n-Propanol, Isopropanol, 1-Butanol, Water, Dioxane,Cyclohexanone, MEK, DMAC, THF, DMF, Dichloromethane, DMSO, Benzene,Toluene, Xylene, Pentane, Chloroform, Trichloroethane,Tetrachloroethane, and Hexane, Heptane, Octane, Cyclohexane,Trichloroethylene and Acetone 0.5 L-Leucine (cyclohexanediol) Methanol,Ethanol, n-Propanol, Isopropanol, 1-Butanol, Water, Dioxane,Cyclohexanone, MEK, 0.5 L-Leucine (hexanediol) sebacinate DMAC, THF,DMF, Dichloromethane, DMSO, Benzene, Toluene, Xylene, Pentane, See [A]Chloroform, Trichloroethane, Tetrachloroethane, and Hexane, Heptane,Octane, Cyclohexane, Trichloroethylene and Acetone L-Phenyl Alanine(propanediol) sebacinate DMAC, THF, DMF, Dichloromethane, DMSO, Water,Dioxane, Cyclohexanone, MEK, See [B] Chloroform, Trichloroethane,Tetrachloroethane, and Benzene, Toluene, Xylene, Pentane,Trichloroethylene Hexane, Heptane, Octane, Cyclohexane, Acetone,Methanol, Ethanol, n-Propanol, Isopropanol, and 1-Butanol

The polymer in the coating that can be subjected to a phase inversionprocess can be any biocompatible polymer. In general, the polymerpreferably has a glass transition temperature (T_(g)) about or aboveambient temperature because the operational temperature for a medicaldevice is generally ambient temperature or body temperature and, if apolymer has a T_(g) below ambient temperature, a solidificationmechanism will not be in place for the polymer in a coating at theoperational temperature of the medical device. Further, a preferredpolymer or polymeric material preferably has a T_(g) above about bodytemperature (e.g., 37° C.) so that the coating structure will not belost upon implantation of the medical device (e.g., a stent). However,in some embodiments, a polymer can have a T_(g) lower than ambienttemperature and be included in a polymer solution subjected to the phaseinversion process described herein. In these embodiments, the polymersolution should have one or more components having a T_(g) above aboutambient or body temperature.

A coating formed from a phase inversion process can have a variety ofmorphologies. Some exemplary forms of morphology include, but are notlimited to, interconnected non-solvent rich phase, isolatednon-solvent-rich phase, and sometimes, a morphology substantially freefrom the non-solvent-rich phase, depending on the total volume of thephase and the rate at which phase inversion occurs. In some embodiments,the coating morphology can have a two-phase structure having poresand/or channels. A newly formed two-phase structure can undergo a briefperiod of pore growth or coarsening to minimize its total interfacialfree energy. The coarsening period can continue until a solidificationmechanism (e.g., glass transition, crystallization) decreases the systemmobility to an extent that all pore or channel growth ceases and thefinal morphology essentially is frozen into place.

The coating morphology can be tailored by controlling the phaseinversion process by varying processing conditions. Such processingconditions can be, for example, selection of solvents, non-solvents, orpolymers for forming the coating, evaporation rate of solvent,processing temperature, ambient humidity, or pressure.

In some embodiments, a coating composition system that includes a PEApolymer, a solvent and a drug can be used to form a coating. Such acoating composition system can have a ternary phase diagram as shown inFIG. 1. Some exemplary PEA polymers include three building blocks: anamino acid, a diol, and a diacid. The diacid can be, for example, a C2to C12 diacid (e.g., aliphatic diacid with or without unsaturation oraromatic diacid). The diol can be, for example, a C2 to C12 diol, whichcan be a straight diol or branch diol with or without unsaturation. Theamino acid can be, for example, glycine, valine, alanine, leucine,isoleucine, and/or phenyl alanine. An optional second amino acid can beincluded, which could include lysine, tyrosine, glutamic acid, orcysteine. The second amino acid can also contain a side group forattaching to a bioactive agent (e.g., pharmacologically activecompound(s)) or property modifier(s). Some exemplary methods of makingPEA are described in U.S. Pat. No. 6,503,538 B1. In some embodiments,the PEA polymer can be synthesized according to Scheme I:

Referring to FIG. 1, three compositions of the coating compositionsystem, labeled A, B and C, are subjected to a phase inversion process.The thermodynamics of the system can be chosen such that the initialcompositions A, B and C follow the indicated mass transfer paths uponsolvent evaporation so as to form three distinct PEA membranemorphologies. Composition A has a sufficiently small quantity of a drugand a non-solvent, such that the binodal curve is never crossed and thedrug and polymer remain in a homogeneous mixture. Because the drug ismiscible with the polymer and remains in the polymer matrix, the drugrelease kinetics is expected to be slower. However, as more drug(non-solvent) is added to the initial solution, the solution can becomeunstable upon solvent evaporation and can phase separate into atwo-phase mixture. As more solvent evaporates, the PEA-rich phase can bedriven into the glass transition region, thereby locking the membranestructure into place. Composition B is expected to have a lower fractionof the dispersed drug-rich phase than composition C. The drug-releaserate will increase as the fraction of the dispersed drug-rich phaseincreases.

In some embodiments, a coating composition system can have a drug,solvent, non-solvent, and a PEA polymer. Such a quaternary system canhave a phase diagram that one of ordinary skill in the art can readilyunderstand.

PEA formulations based on different solvents or different drugs can havedifferent phase diagrams and different phase inversion dynamics, whichallow the design of systems with varied morphologies and, thus,release-rate kinetics. For example, parameters such as solventevaporation rate, solvent/non-solvent affinity, etc., can influence thephase inversion rate and thus will impact the final membrane structure.To illustrate, a solvent with a high evaporation rate (1) can cool thecoating to induce a phase inversion, (2) can impart roughness orcoarseness to the coating, and (3) can sometimes form channels or poresin the coating. The solvent/non-solvent affinity can affect the coatingmorphology in many ways. For example, if solvent and non-solvent arecompletely miscible, there will be rapid solvent exchange, leading tothe formation of channels within the coating. If solvent and non-solventare nearly immiscible, solvent exchange will be slow and a coatingformed therefrom will have a dense and less porous morphology. Ifsolvent and non-solvent have limited solubility (between the twoextremes), then solvent exchange will be moderate and a coating formedtherefrom will be porous. This phenomenon is linked to to the phaseinversion rate discussion below. As used herein, the term “porous” canrefer to a coating having pores or channels. In some embodiments, theterm “porous” can refer to a coating having solvent rich/polymer lean ornon-solvent rich/polymer lean areas or regions.

Variation of coating polymers can also affect the dynamics of the phaseinversion process. In general, fast phase inversion rates result in alarge fraction of the two-phase system being in the non-solvent-richphase. Additionally, this phase can be interconnected or take a formsuch as honeycomb structure, finger-type structure or the like. Suchtypes of morphologies can exhibit faster drug release kinetics.Conversely, slower phase inversion rates can result in smaller fractionbeing non-solvent rich. In addition, the non-solvent rich phase may ormay not be interconnected, resulting in phase structures ranging fromdense structure with isolated, non-solvent pockets to honeycomb-typestructures. Such types of morphologies will exhibit slower drug releasekinetics.

In some embodiments, use of surfactant can be a formulation variablewith which to control the size, shape, and gradient of the dispersedphase (i.e., the drug rich phase). The release rate of a drug can be afunction of size distribution, shape, and gradient of the dispersedphase. Therefore, in some embodiments, a surfactant can be included in acoating composition system that would lower the interfacial tensionduring the phase inversion process and reduce the coarsening of thedispersed phase after the induction of the binodal decomposition. Anybiocompatible surfactant, such as Pluronic™ (poly(ethyleneoxide)-polypropylene oxide)-poly(ethylene oxide), Tetronic™(tetra-functional block copolymers based on ethylene oxide and propyleneoxide such as Polyol, available from BASF Corporation, Mount Olive,N.J.), Tween (Polysorbate surfactants), Span (Sorbitan based surfactantsuch as Sorbitan Monostearate), Brij (Polyoxyethylene based surfactantsuch as polyoxyethylene (20) Oleyl ether), Myrj (polyoxyethylene basedsurfactant such as Polyoxyethylene monostearate), Silwet (trisiloxanebased surfactant), phospholipids, Poloxamer and combinations thereof,can be an exemplary surfactant that can be included in the coatingcomposition system.

In some embodiments, a phase inversion process can be modulated by, forexample, controlling the solvent evaporation rate in the phase inversionprocess so as to control the kinetics of the solid phase evolution in acoating. For example, the coating composition can additionally includean ingredient having a different boiling point from the solvent so as toincrease or decrease the evaporation rate of the solvent. Thisingredient can be a solvent or a non-solvent of a polymer in the coatingcomposition.

According to the ternary phase diagram described above, anabsorption-rate-controlled drug release can be a zero order release if,during the phase inversion process, the mass transfer line does notcross the binodal zone and the drug remains in the solid solution (see,FIG. 1). In this embodiment, the drug is soluble in the polymer matrixcoating. Accordingly, in some embodiments, a phase inversion process asdescribed herein can be used to form a coating having a drug releasethat is proportional to the absorption rate of the polymer matrix. Asused herein, the term “zero order release” refers to a release profilewhere the release rate of a drug or agent remains unchanged orsubstantially unchanged over time after an onset release of the drug oragent. Similarly, a zero order absorption rate of a polymer refers to arate of absorption of a polymer that remains unchanged or substantiallyunchanged over time.

In some embodiments, the phase conversion process described herein canbe used to control mechanical properties of a coating. Mechanicalproperties are related to coating morphologies, the control of which isdescribed above. For example, a coating having a dense morphology can bemechanically stronger than a coating having a large number of pores orchannels.

Biocompatible Polymers

Any biocompatible polymer or polymeric material having a glasstransition temperature greater than about ambient temperature can beused to form a coating composition that can be subjected to the phaseinversion process described above in forming a coating on a medicaldevice. The biocompatible polymer can be biodegradable (eitherbioerodable or bioabsorbable or both) or nondegradable, and can behydrophilic or hydrophobic.

Representative biocompatible polymers include, but are not limited to,poly(ester amide), polyhydroxyalkanoates (PHA),poly(3-hydroxyalkanoates) such as poly(3-hydroxypropanoate),poly(3-hydroxybutyrate), poly(3-hydroxyvalerate),poly(3-hydroxyhexanoate), poly(3-hydroxyheptanoate) andpoly(3-hydroxyoctanoate), poly(4-hydroxyalkanaote) such aspoly(4-hydroxybutyrate), poly(4-hydroxyvalerate),poly(4-hydroxyhexanote), poly(4-hydroxyheptanoate),poly(4-hydroxyoctanoate) and copolymers including any of the3-hydroxyalkanoate or 4-hydroxyalkanoate monomers described herein orblends thereof, poly(D,L-lactide), poly(L-lactide), polyglycolide,poly(D,L-lactide-co-glycolide), poly(L-lactide-co-glycolide),polycaprolactone, poly(lactide-co-caprolactone),poly(glycolide-co-caprolactone), poly(dioxanone), poly(ortho esters),poly(anhydrides), poly(tyrosine carbonates) and derivatives thereof,poly(tyrosine ester) and derivatives thereof, poly(imino carbonates),poly(glycolic acid-co-trimethylene carbonate), polyphosphoester,polyphosphoester urethane, poly(amino acids), polycyanoacrylates,poly(trimethylene carbonate), poly(iminocarbonate), polyphosphazenes,silicones, polyesters, polyolefins, polyisobutylene andethylene-alphaolefin copolymers, acrylic polymers and copolymers, vinylhalide polymers and copolymers, such as polyvinyl chloride, polyvinylethers, such as polyvinyl methyl ether, polyvinylidene halides, such aspolyvinylidene chloride, polyacrylonitrile, polyvinyl ketones, polyvinylaromatics, such as polystyrene, polyvinyl esters, such as polyvinylacetate, copolymers of vinyl monomers with each other and olefins, suchas ethylene-methyl methacrylate copolymers, acrylonitrile-styrenecopolymers, ABS resins, and ethylene-vinyl acetate copolymers,polyamides, such as Nylon 66 and polycaprolactam, alkyd resins,polycarbonates, polyoxymethylenes, polyimides, polyethers, poly(glycerylsebacate), poly(propylene fumarate), poly(n-butyl methacrylate),poly(sec-butyl methacrylate), poly(isobutyl methacrylate),poly(tert-butyl methacrylate), poly(n-propyl methacrylate),poly(isopropyl methacrylate), poly(ethyl methacrylate), poly(methylmethacrylate), epoxy resins, polyurethanes, rayon, rayon-triacetate,cellulose acetate, cellulose butyrate, cellulose acetate butyrate,cellophane, cellulose nitrate, cellulose propionate, cellulose ethers,carboxymethyl cellulose, polyethers such as poly(ethylene glycol) (PEG),copoly(ether-esters) (e.g. poly(ethylene oxide-co-lactic acid)(PEO/PLA)), polyalkylene oxides such as poly(ethylene oxide),polypropylene oxide), poly(ether ester), polyalkylene oxalates,phosphoryl choline, choline, poly(aspirin), polymers and co-polymers ofhydroxyl bearing monomers such as 2-hydroxyethyl methacrylate (HEMA),hydroxypropyl methacrylate (HPMA), hydroxypropylmethacrylamide, PEGacrylate (PEGA), PEG methacrylate,2-methacryloyloxyethylphosphorylcholine (MPC) and n-vinyl pyrrolidone(VP), carboxylic acid bearing monomers such as methacrylic acid (MA),acrylic acid (AA), alkoxymethacrylate, alkoxyacrylate, and3-trimethylsilylpropyl methacrylate (TMSPMA),poly(styrene-isoprene-styrene)-PEG (SIS-PEG), polystyrene-PEG,polyisobutylene-PEG, polycaprolactone-PEG (PCL-PEG), PLA-PEG,poly(methyl methacrylate)-PEG (PMMA-PEG), polydimethylsiloxane-co-PEG(PDMS-PEG), poly(vinylidene fluoride)-PEG (PVDF-PEG), Pluronic™surfactants (polypropylene oxide-co-polyethylene glycol),poly(tetramethylene glycol), hydroxy functional poly(vinyl pyrrolidone),biomolecules such as collagen, chitosan, alginate, fibrin, fibrinogen,cellulose, starch, dextran, dextrin, hyaluronic acid, fragments andderivatives of hyaluronic acid, heparin, fragments and derivatives ofheparin, glycosamino glycan (GAG), GAG derivatives, polysaccharide,elastin, or combinations thereof. In some embodiments, the coatings canexclude any one of the aforementioned polymers.

As used herein, the terms poly(D,L-lactide), poly(L-lactide),poly(D,L-lactide-co-glycolide), and poly(L-lactide-co-glycolide) can beused interchangeably with the terms poly(D,L-lactic acid), poly(L-lacticacid), poly(D,L-lactic acid-co-glycolic acid), or poly(L-lacticacid-co-glycolic acid), respectively.

Biobeneficial Material

In some embodiments, the biocompatible polymer or polymeric materialdescribed above can include a biobeneficial material. The biobeneficialmaterial can be a polymeric material or non-polymeric material. Thebiobeneficial material is preferably non-toxic, non-antigenic andnon-immunogenic. A biobeneficial material is one which enhances thebiocompatibility of the coating or device by being non-fouling,hemocompatible, actively non-thrombogenic, or anti-inflammatory, allwithout depending on the release of a pharmaceutically active agent.

Representative biobeneficial materials include, but are not limited to,polyethers such as poly(ethylene glycol), copoly(ether-esters) (e.g.PEO/PLA), polyalkylene oxides such as poly(ethylene oxide),poly(propylene oxide), poly(ether ester), polyalkylene oxalates,polyphosphazenes, phosphoryl choline, choline, poly(aspirin), polymersand co-polymers of hydroxyl bearing monomers such as hydroxyethylmethacrylate (HEMA), hydroxypropyl methacrylate (HPMA),hydroxypropylmethacrylamide, poly (ethylene glycol) acrylate (PEGA), PEGmethacrylate, 2-methacryloyloxyethylphosphorylcholine (MPC) and n-vinylpyrrolidone (VP), carboxylic acid bearing monomers such as methacrylicacid (MA), acrylic acid (AA), alkoxymethacrylate, alkoxyacrylate, and3-trimethylsilylpropyl methacrylate (TMSPMA),poly(styrene-isoprene-styrene)-PEG (SIS-PEG), polystyrene-PEG,polyisobutylene-PEG, polycaprolactone-PEG (PCL-PEG), PLA-PEG,poly(methyl methacrylate)-PEG (PMMA-PEG), polydimethylsiloxane-co-PEG(PDMS-PEG), poly(vinylidene fluoride)-PEG (PVDF-PEG), Pluronic™surfactants (polypropylene oxide-co-polyethylene glycol),poly(tetramethylene glycol), hydroxy functional poly(vinyl pyrrolidone),biomolecules such as fibrin, fibrinogen, cellulose, starch, collagen,dextran, dextrin, hyaluronic acid, fragments and derivatives ofhyaluronic acid, heparin, fragments and derivatives of heparin,glycosamino glycan (GAG), GAG derivatives, polysaccharide, elastin,chitosan, alginate, silicones, PolyActive™, and combinations thereof. Insome embodiments, the coatings can exclude any one of the aforementionedpolymers.

The term PolyActive™ refers to a block copolymer having flexiblepoly(ethylene glycol) and poly(butylene terephthalate) blocks(PEGT/PBT). PolyActive™ is intended to include AB, ABA, BAB copolymershaving such segments of PEG and PBT (e.g., poly(ethyleneglycol)-block-poly(butyleneterephthalate)-block poly(ethylene glycol)(PEG-PBT-PEG).

In a preferred embodiment, the biobeneficial material can be a polyethersuch as poly (ethylene glycol) (PEG) or polyalkylene oxide.

Bioactive Agents

A coating composition system that can be subjected to the phaseinversion described above can include any bioactive agent. The bioactiveagent can be any bioactive agent, which is a therapeutic, prophylactic,or diagnostic agent. These agents can have anti-proliferative oranti-inflammatory properties or can have other properties such asantineoplastic, antiplatelet, anti-coagulant, anti-fibrin,antithrombotic, antimitotic, antibiotic, antiallergic, and antioxidant.The agents can be cytostatic agents, agents that promote the healing ofthe endothelium such as NO releasing or generating agents, agents thatattract endothelial progenitor cells, or agents that promote theattachment, migration and proliferation of endothelial cells (e.g.,natriuretic peptide such as CNP, ANP or BNP peptide or an RGD or cRGDpeptide), while quenching smooth muscle cell proliferation. Examples ofsuitable therapeutic and prophylactic agents include synthetic inorganicand organic compounds, proteins and peptides, polysaccharides and othersugars, lipids, and DNA and RNA nucleic acid sequences havingtherapeutic, prophylactic or diagnostic activities. Some other examplesof the bioactive agent include antibodies, receptor ligands, enzymes,adhesion peptides, blood clotting factors, inhibitors or clot dissolvingagents such as streptokinase and tissue plasminogen activator, antigensfor immunization, hormones and growth factors, oligonucleotides such asantisense oligonucleotides and ribozymes and retroviral vectors for usein gene therapy. Examples of anti-proliferative agents include rapamycinand its functional or structural derivatives,40-O-(2-hydroxy)ethyl-rapamycin (everolimus), and its functional orstructural derivatives, paclitaxel and its functional and structuralderivatives. Examples of rapamycin derivatives include40-epi-(N1-tetrazolyl)-rapamycin (ABT-578),40-O-(3-hydroxy)propyl-rapamycin,40-O-[2-(2-hydroxy)ethoxy]ethyl-rapamycin, and 40-O-tetrazole-rapamycin.Examples of paclitaxel derivatives include docetaxel. Examples ofantineoplastics and/or antimitotics include methotrexate, azathioprine,vincristine, vinblastine, fluorouracil, doxorubicin hydrochloride (e.g.Adriamycin® from Pharmacia & Upjohn, Peapack N.J.), and mitomycin (e.g.Mutamycin® from Bristol-Myers Squibb Co., Stamford, Conn.). Examples ofsuch antiplatelets, anticoagulants, antifibrin, and antithrombinsinclude sodium heparin, low molecular weight heparins, heparinoids,hirudin, argatroban, forskolin, vapiprost, prostacyclin and prostacyclinanalogues, dextran, D-phe-pro-arg-chloromethylketone (syntheticantithrombin), dipyridamole, glycoprotein IIb/IIIa platelet membranereceptor antagonist antibody, recombinant hirudin, thrombin inhibitorssuch as Angiomax (Biogen, Inc., Cambridge, Mass.), calcium channelblockers (such as nifedipine), colchicine, fibroblast growth factor(FGF) antagonists, fish oil (omega 3-fatty acid), histamine antagonists,lovastatin (an inhibitor of HMG-CoA reductase, a cholesterol loweringdrug, brand name Mevacor® from Merck & Co., Inc., Whitehouse Station,N.J.), monoclonal antibodies (such as those specific forPlatelet-Derived Growth Factor (PDGF) receptors), nitroprusside,phosphodiesterase inhibitors, prostaglandin inhibitors, suramin,serotonin blockers, steroids, thioprotease inhibitors,triazolopyrimidine (a PDGF antagonist), nitric oxide or nitric oxidedonors, super oxide dismutases, super oxide dismutase mimetic,4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl (4-amino-TEMPO), estradiol,anticancer agents, dietary supplements such as various vitamins, and acombination thereof. Examples of anti-inflammatory agents includingsteroidal and non-steroidal anti-inflammatory agents include tacrolimus,dexamethasone, clobetasol, or combinations thereof. Examples ofcytostatic substances include angiopeptin, angiotensin converting enzymeinhibitors such as captopril (e.g. Capoten® and Capozide® fromBristol-Myers Squibb Co., Stamford, Conn.), cilazapril or lisinopril(e.g. Prinivil® and Prinzide® from Merck & Co., Inc., WhitehouseStation, N.J.). An example of an antiallergic agent is permirolastpotassium. Other therapeutic substances or agents which may beappropriate include alpha-interferon, pimecrolimus, imatinib mesylate,midostaurin, bioactive RGD, and genetically engineered endothelialcells. The foregoing substances can also be used in the form of prodrugsor co-drugs thereof. The foregoing substances also include metabolitesthereof and/or prodrugs of the metabolites. The foregoing substances arelisted by way of example and are not meant to be limiting. Other activeagents which are currently available or that may be developed in thefuture are equally applicable.

The dosage or concentration of the bioactive agent required to produce afavorable therapeutic effect should be less than the level at which thebioactive agent produces toxic effects and greater than the level atwhich non-therapeutic results are obtained. The dosage or concentrationof the bioactive agent can depend upon factors such as the particularcircumstances of the patient, the nature of the trauma, the nature ofthe therapy desired, the time over which the ingredient administeredresides at the vascular site, and if other active agents are employed,the nature and type of the substance or combination of substances.Therapeutic effective dosages can be determined empirically, for exampleby infusing vessels from suitable animal model systems and usingimmunohistochemical, fluorescent or electron microscopy methods todetect the agent and its effects, or by conducting suitable in vitrostudies. Standard pharmacological test procedures to determine dosagesare understood by one of ordinary skill in the art.

Examples of Implantable Device

As used herein, an implantable device may be any suitable medicalsubstrate that can be implanted in a human or veterinary patient.Examples of such implantable devices include self-expandable stents,balloon-expandable stents, stent-grafts, grafts (e.g., aortic grafts),heart valve prostheses, cerebrospinal fluid shunts, pacemakerelectrodes, catheters, endocardial leads (e.g., FINELINE and ENDOTAK,available from Guidant Corporation, Santa Clara, Calif.), anastomoticdevices (e.g., CABG anastomotic clips) and connectors, orthopedicimplants such as screws, spinal implants, and electro-stimulatorydevices. The underlying structure of the device can be of virtually anydesign. The device can be made of a metallic material or an alloy suchas, but not limited to, cobalt chromium alloy (ELGILOY), stainless steel(316L), high nitrogen stainless steel, e.g., BIODUR 108, cobalt chromealloy L-605, “MP35N,” “MP20N,” ELASTINITE (Nitinol), tantalum,nickel-titanium alloy, platinum-iridium alloy, gold, magnesium, orcombinations thereof “MP35N” and “MP20N” are trade names for alloys ofcobalt, nickel, chromium and molybdenum available from Standard PressSteel Co., Jenkintown, Pa. “MP35N” consists of 35% cobalt, 35% nickel,20% chromium, and 10% molybdenum. “MP20N” consists of 50% cobalt, 20%nickel, 20% chromium, and 10% molybdenum. Devices made frombioabsorbable or biostable polymers could also be used with theembodiments of the present invention. In some embodiments, the device isa absorbable stent.

Method of Use

In accordance with embodiments of the invention, a coating subjected tothe treatment of a phase inversion process described above can be usedto provided controlled release of a bioactive agent from a medicaldevice (e.g., stent) during delivery and (in the case of a stent)expansion of the device, or thereafter, at a desired rate and for apredetermined time at the implantation site.

Preferably, the medical device is a stent. The stent described herein isuseful for a variety of medical procedures, including, for example,treatment of obstructions caused by tumors in bile ducts, esophagus,trachea/bronchi and other biological passageways. A stent having theabove-described coating is particularly useful for treating diseasedregions of blood vessels caused by lipid deposition, monocyte ormacrophage infiltration, or dysfunctional endothelium or a combinationthereof, or occluded regions of blood vessels caused by abnormal orinappropriate migration and proliferation of smooth muscle cells,thrombosis, and restenosis. Stents may be placed in a wide array ofblood vessels, both arteries and veins. Representative examples of sitesinclude the iliac, renal, carotid and coronary arteries.

For implantation of a stent, an angiogram is first performed todetermine the appropriate positioning for stent therapy. An angiogram istypically accomplished by injecting a radiopaque contrasting agentthrough a catheter inserted into an artery or vein as an x-ray is taken.A guidewire is then advanced through the lesion or proposed site oftreatment. Over the guidewire is passed a delivery catheter that allowsa stent in its collapsed configuration to be inserted into thepassageway. The delivery catheter is inserted either percutaneously orby surgery into the femoral artery, brachial artery, femoral vein, orbrachial vein, and advanced into the appropriate blood vessel bysteering the catheter through the vascular system under fluoroscopicguidance. A stent having the above-described features may then beexpanded at the desired area of treatment. A post-insertion angiogrammay also be utilized to confirm appropriate positioning.

While particular embodiments of the present invention have been shownand described, it will be obvious to those skilled in the art thatchanges and modifications can be made without departing from thisinvention in its broader aspects. Therefore, the appended claims are toencompass within their scope all such changes and modifications as fallwithin the true spirit and scope of this invention.

1. A method of treating a disorder in a patient comprising implanting ina patient the medical device formed according to a method whichcomprises providing a coating composition comprising a polymer and asolvent of the polymer, applying the coating composition onto themedical device, inducing phase inversion in the coating composition, andcausing the coating composition to form a layer of the coating on themedical device, wherein the coating has a controlled morphology forcontrolling the release of an agent from the coating.
 2. The method ofclaim 1, wherein phase inversion is induced by quenching the coatingcomposition.
 3. The method of claim 2, wherein quenching comprisesevaporation of the solvent.
 4. The method of claim 1, wherein thecoating composition further comprises a non-solvent of the polymer. 5.The method of claim 4, wherein the non-solvent is a bioactive agent. 6.The method of claim 1, wherein the phase inversion is induced byevaporation of the solvent.
 7. The method of claim 1, wherein phaseinversion is induced by introducing water into the layer of the coatingcomposition.
 8. The method of claim 7, wherein the water is introducedinto the layer by condensation or absorption of water into the layer. 9.The method of claim 1, wherein phase inversion is thermally induced. 10.The method of claim 9, wherein phase inversion is induced by cooling thelayer of the coating composition by (a) evaporation of the solvent, (b)application of a cold stream of gas, or (c) placement in a coldenvironment.
 11. The method of claim 1, wherein the coating comprises atwo-phase morphology.
 12. The method of claim 11, wherein the morphologycomprises a non-solvent rich phase.
 13. The method of claim 12, whereinthe non-solvent-rich phase is isolated or interconnected.
 14. The methodof claim 13, wherein isolated non-solvent rich phase means that thephase comprises isolated non-solvent pockets, and interconnectednon-solvent rich phase means that the phase comprises a honeycomb-typeor a finger-type structure.
 15. The method of claim 1, wherein thepolymer comprises a poly(ester amide) polymer.
 16. The method of claim1, wherein the coating composition further comprises a surfactant. 17.The method of claim 16, wherein the surfactant is selected from thegroup consisting of Pluronic™, Tetronic™, Tween surfactants, Spansurfactants, Brij surfactants, Myrj surfactants, Silwet surfactants,phospholipids, Poloxamer and combinations thereof.
 18. The method ofclaim 1, wherein the polymer has a glass transition temperature aboveambient temperature.
 19. The method of claim 18, wherein the polymer hasa glass transition temperature above about 37° C.
 20. The method ofclaim 1, wherein the coating has a rough or coarse morphology or thecoating has a two-phase morphology with channels or pores.
 21. Themethod of claim 4, wherein the non-solvent is a drug.
 22. The method ofclaim 21, wherein the drug is selected from the group consisting ofpaclitaxel, docetaxel, estradiol, 17-beta-estradiol, nitric oxidedonors, super oxide dismutases, super oxide dismutases mimics,4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl (4-amino-TEMPO), biolimus,tacrolimus, dexamethasone, rapamycin, rapamycin derivatives,40-O-(2-hydroxy)ethyl-rapamycin (everolimus),40-O-(3-hydroxy)propyl-rapamycin,40-O-[2-(2-hydroxy)ethoxy]ethyl-rapamycin, and 40-O-tetrazole-rapamycin,40-epi-(N1-tetrazolyl)-rapamycin (ABT-578), clobetasol, pimecrolimus,imatinib mesylate, midostaurin, prodrugs thereof, co-drugs thereof, anda combination thereof.
 23. The method of claim 1, wherein the coatingcomposition further comprises a drug soluble in the polymer.
 24. Themethod of claim 1, wherein phase inversion is induced by (a)lyophilizing the solvent from the polymer, (b) extracting the solventfrom the polymer using a non-solvent for the polymer, (c) extracting thesolvent from the polymer using supercritical extraction, (d) removingthe solvent by vacuum heating, or (e) removing the solvent by vacuum atroom temperature.
 25. The method of claim 1, wherein the medical deviceis a stent.
 26. The method of claim 1, wherein the medical device is abioabsorbable stent.
 27. The method of claim 1, wherein the polymer hasa zero order absorption rate.
 28. The method of claim 1, wherein thecoating has a rough or coarse morphology or a morphology with channelsor pores.
 29. The method of claim 23, wherein the drug has a zero orderrelease profile.
 30. The method of claim 23, wherein the drug has a rateof release which is proportional to the absorption rate of the polymer.31. The method of claim 1, wherein the disorder is selected from thegroup consisting of atherosclerosis, thrombosis, restenosis, hemorrhage,vascular dissection or perforation, vascular aneurysm, vulnerableplaque, chronic total occlusion, claudication, anastomotic proliferationfor vein and artificial grafts, bile duct obstruction, ureterobstruction, tumor obstruction, and combinations thereof.